Palliative Care in the Acute Care Surgery Setting
Fig. 39.1 Palliative care model. Adapted from United States Department of Health and Human Services Surgeon’s Role in Palliative Care Prior to the start of the hospice movement in the…
CRITICAL CARE
The Open Abdomen
Moore [9] • Medical bleeding due to coagulopathy • Inaccessible major venous injury • Need for a time-consuming procedure in an under-resuscitated patient • Need for control of extra-abdominal, life-threatening injury • Inability to close…
Metabolic and Anatomic Complications Following Bariatric Surgery
Complications of bariatric surgery Short-term (first 30–90 days) Long-term Nausea/vomiting Fistulae •Gastro-gastric, gastro-cutaneous, etc. Dehydration Diarrhea •Maldigestion, malabsorption, bacterial overgrowth Fatigue Dumping Anastomotic stricture Reactive hypoglycemia Leaks/sepsis Failure to maintain…
Complications of Laparoendoscopic Surgery
5. Tait IS, Krige JE, Terblanche J. Endoscopic band ligation of esophageal varices. Br J Surg. 1999;86(4):437–46.PubMedCrossRef 6. Barkun AN, Bardou M, Kuipers EJ, Sung J, Hunt RH, Martel M,…
Early Management of Sepsis, Severe Sepsis, and Septic Shock in the Surgical Patient
Systemic inflammatory response syndrome (SIRS) criteria Two or more of the following criteria must be present: •Body temperature less than 36°C or greater than 38°C •Heart rate greater than 90…
Upper Gastrointestinal Bleeding
Etiology Frequency (%) Duodenal ulcer 33.2 Gastric ulcer 16.9 Varices 11.5 Gastric erosions 10.4 Neoplasms 5.2 Esophagitis 4.3 Mallory–Weiss lesions 3.2 Anastomotic ulcer 3.0 Vascular malformations 2.8 Rare causes, including…
Incarcerated Paraesophageal Hernia
Fig. 16.1 Paraesophageal hernia types. A type I hernia is characterized by an upward dislocation of the gastroesophageal (GE) junction and the cardia of the stomach through the attenuated phrenoesophageal…
Acute Renal Insufficiency (Failure)
Introduction One of the primary roles of the kidneys is to filter waste material from the blood. The inability of the kidneys to do this leads to renal failure. Acute…
Perioperative Considerations for Surgical Emergencies
Risk stratification Procedure examples Vascular (reported cardiac risk often more than 5%) Aortic and other major vascular surgery Peripheral vascular surgery Intermediate (reported cardiac risk generally 1–5%) Intraperitoneal and intrathoracic…
Acute Lung Injury in the Acute Care Surgery Patient
Cytokine Action IL-1β (beta) Increased vascular permeability and apoptosis of epithelial cells IL-8 Increased neutrophil aggregation and activation TNF-α (alpha) Induction of inflammation, cachexia, and increased transcription of cytokines TGF-β…
